School immunization requirements exist to protect students and members of their community from serious vaccine preventable diseases by ensuring high vaccine rates. These requirements are established by the Massachusetts Department of Public Health.

Massachusetts students must provide documentation of immunization according to school requirements, or show a medical or religious exemption. Medical exemptions come from the student's doctor and document a contraindication, which is a reason why an individual cannot medically receive the vaccine. Religious exemptions come from the parent/guardian and state in writing that a vaccine conflicts with his/her sincerely held religious belief. Medical and religious exemption letters must be documented with each school year.